Show simple item record

dc.contributor.authorMotamed, Payam K.
dc.contributor.authorGarcia, Julio
dc.contributor.authorDahdah, Nagib
dc.contributor.authorKadem, Lyes
dc.contributor.authorKeshavarz Motamed, Zahra
dc.contributor.authorEdelman, Elazer R
dc.date.accessioned2017-05-08T14:07:23Z
dc.date.available2017-05-08T14:07:23Z
dc.date.issued2015-10
dc.date.submitted2015-10
dc.identifier.issn0021-9290
dc.identifier.urihttp://hdl.handle.net/1721.1/108732
dc.description.abstractEarly detection and accurate estimation of the extent of coarctation of the aorta (COA) is critical to long-term outcome. Peak-to-peak trans-coarctation pressure gradient (PKdP) higher than 20 mmHg is an indication for interventional/surgical repair. Patients with COA have reduced proximal and distal aortic compliances. A comprehensive study investigating the effects of variations of proximal COA and systemic compliances on PKdP, and consequently on the COA severity evaluation has never been done. This study evaluates the effect of aortic compliance on diagnostic accuracy of PKdP. Lumped parameter modeling and in vitro experiments were performed for COA severities of 50%, 75% and 90% by area. Modeling and in vitro results were validated against retrospective clinical data of PKdP, measured in 54 patients with COA. Modeling and in vitro. PKdP increases with reduced proximal COA compliance (+36%, +38% and +53% for COA severities of 50%, 75% and 90%, respectively; p<0.05), but decreases with reduced systemic compliance (−62%, −41% and −36% for COA severities of 50%, 75% and 90%, respectively; p<0.01). Clinical study. PKdP has a modest correlation with COA severity (R=0.29). The main determinants of PKdP are COA severity, stroke volume index and systemic compliance. Systemic compliance was found to be as influential as COA severity in PKdP determination (R=0.30 vs. R =0.34). In conclusion, PKdP is highly influenced by both stroke volume index and arterial compliance. Low values of PKdP cannot be used to exclude the severe COA presence since COA severity may be masked by reduced systemic compliance and/or low flow conditions.en_US
dc.language.isoen_US
dc.publisherElsevieren_US
dc.relation.isversionofhttp://dx.doi.org/10.1016/j.jbiomech.2015.10.017en_US
dc.rightsCreative Commons Attribution-NonCommercial-NoDerivs Licenseen_US
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/en_US
dc.sourcePMCen_US
dc.titleThe role of aortic compliance in determination of coarctation severity: Lumped parameter modeling, in vitro study and clinical evaluationen_US
dc.typeArticleen_US
dc.identifier.citationKeshavarz-Motamed, Zahra; Edelman, Elazer R.; Motamed, Payam K.; Garcia, Julio; Dahdah, Nagib and Kadem, Lyes. “The Role of Aortic Compliance in Determination of Coarctation Severity: Lumped Parameter Modeling, in Vitro Study and Clinical Evaluation.” Journal of Biomechanics 48, no. 16 (December 2015): 4229–4237. © 2015 Elsevier Ltden_US
dc.contributor.departmentInstitute for Medical Engineering and Scienceen_US
dc.contributor.departmentHarvard University--MIT Division of Health Sciences and Technologyen_US
dc.contributor.mitauthorKeshavarz Motamed, Zahra
dc.contributor.mitauthorEdelman, Elazer R
dc.relation.journalJournal of Biomechanicsen_US
dc.eprint.versionAuthor's final manuscripten_US
dc.type.urihttp://purl.org/eprint/type/JournalArticleen_US
eprint.statushttp://purl.org/eprint/status/PeerRevieweden_US
dspace.orderedauthorsKeshavarz-Motamed, Zahra; Edelman, Elazer R.; Motamed, Payam K.; Garcia, Julio; Dahdah, Nagib; Kadem, Lyesen_US
dspace.embargo.termsNen_US
dc.identifier.orcidhttps://orcid.org/0000-0001-5853-3887
dc.identifier.orcidhttps://orcid.org/0000-0002-7832-7156
mit.licensePUBLISHER_CCen_US


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record